Alt Ekstremite Periferik Arter Hastalığında Endovasküler Girişimlerden Kaynaklanan Akut Komplikasyonların Cerrahi Yönetimi: Eskimeyen Yeni

Abstract

Aim: The importance of endovascular procedures in the diagnosis and treatment of peripheral vascular diseases has seen a notable rise in recent years. Nevertheless, this surge has resulted in a corresponding rise in iatrogenic vascular complications and subsequent interventions associated with peripheral endovascular procedures. This study involved a retrospective evaluation of acute complications associated with endovascular treatments performed for lower limb peripheral artery diseases, as well as a closer look of the related therapeutic strategies for these challenges. Materials and Methods: A retrospective evaluation was conducted on a cohort of 400 patients who received endovascular intervention for lower extremity peripheral artery disease at our clinic. The study included 27 patients (6.7%) from this cohort who received surgical or endovascular treatment for acute complications following endovascular intervention. Our preference for endovascular or surgical treatments was chosen based on the type and localization of the complications. Results: The mean age of patients who experienced complications was 63.7±6 years. The complications were as follows in order of frequency: dissection 14 (51.9%) patients, arterial perforation 5 (18.5%) patients, major hematoma 3 (11.1%) patients, pseudoaneurysm 2 (7.4%) patients, distal embolism 2 (7.4%) patients and arterio-venous fistula 1 (3.7%) patient. In the treatment of complications, endovascular methods were preferred in 19 (4.7%) patients and surgical approaches were used in 8 (2%) patients. Following endovascular intervention, minor amputation was performed in one patient. Conclusion: The rapid and effective management of complications related to peripheral endovascular procedures in the lower extremities is of utmost importance. Despite the notable advancements in endovascular procedures in recent years, there are scenarios where these interventions may be insufficient for dealing with complications. The management of such problems may necessitate surgical intervention. Hence, the integration of well-established and validated vascular surgical techniques with endovascular interventions is believed to yield optimal outcomes.